Background: Traumatic retroperitoneal hematoma in the iliacus muscle is an
unusual but potentially serious cause of femoral compression neuropathy. Ca
se report: We describe the clinical, imaging, and management features of a
case of traumatic iliacus retroperitoneal hematoma with delayed manifestati
on of femoral neuropathy. Discussion: The anatomical substrate for hematoma
formation with subacute compression of the femoral nerve is emphasized. A
subacute compartment syndrome with progressive edema, swelling and ischemia
of iliacus compartment is suggested as the underlying cause. Early fasciot
omy with or without hematoma evacuation should be considered in order to pr
ovide rapid decompression and to minimize the chance of permanent nerve inj
ury.